title: A WAO - ARIA - GA²LEN consensus document on molecular-based allergy diagnostics.
abstract: Molecular-based allergy (MA) diagnostics is an approach used to map the allergen sensitization of a patient at a molecular level, using purified natural or recombinant allergenic molecules (allergen components) instead of allergen extracts. Since its introduction, MA diagnostics has increasingly entered routine care, with currently more than 130 allergenic molecules commercially available for in vitro specific IgE (sIgE) testing.MA diagnostics allows for an increased accuracy in allergy diagnosis and prognosis and plays an important role in three key aspects of allergy diagnosis: (1) resolving genuine versus cross-reactive sensitization in poly-sensitized patients, thereby improving the understanding of triggering allergens; (2) assessing, in selected cases, the risk of severe, systemic versus mild, local reactions in food allergy, thereby reducing unnecessary anxiety for the patient and the need for food challenge testing; and (3) identifying patients and triggering allergens for specific immunotherapy (SIT).Singleplex and multiplex measurement platforms are available for MA diagnostics. The Immuno-Solid phase Allergen Chip (ISAC) is the most comprehensive platform currently available, which involves a biochip technology to measure sIgE antibodies against more than one hundred allergenic molecules in a single assay. As the field of MA diagnostics advances, future work needs to focus on large-scale, population-based studies involving practical applications, elucidation and expansion of additional allergenic molecules, and support for appropriate test interpretation. With the rapidly expanding evidence-base for MA diagnosis, there is a need for allergists to keep abreast of the latest information. The aim of this consensus document is to provide a practical guide for the indications, determination, and interpretation of MA diagnostics for clinicians trained in allergology.
authors.affiliation: Allergy & Respiratory, DIMI, Department of Internal Medicine, University of Genoa, Largo Rosanna Benzi, Genoa, Italy. canonica@unige.it.
authors.forename: Giorgio Walter
authors.initials: GW
authors.lastname: Canonica
authors.forename: Ignacio J
authors.initials: IJ
authors.lastname: Ansotegui
authors.forename: Ruby
authors.initials: R
authors.lastname: Pawankar
authors.forename: Peter
authors.initials: P
authors.lastname: Schmid-Grendelmeier
authors.forename: Marianne
authors.initials: M
authors.lastname: van Hage
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Baena-Cagnani
authors.forename: Giovanni
authors.initials: G
authors.lastname: Melioli
authors.forename: Carlos
authors.initials: C
authors.lastname: Nunes
authors.forename: Giovanni
authors.initials: G
authors.lastname: Passalacqua
authors.forename: Lanny
authors.initials: L
authors.lastname: Rosenwasser
authors.forename: Hugh
authors.initials: H
authors.lastname: Sampson
authors.forename: Joaquin
authors.initials: J
authors.lastname: Sastre
authors.forename: Jean
authors.initials: J
authors.lastname: Bousquet
authors.forename: Torsten
authors.initials: T
authors.lastname: Zuberbier